Department for Digital, Culture, Media and Sport

Broadband

Chi Onwurah: To ask the Secretary of State for Digital, Culture, Media and Sport, whether the delivery of the Local Full Fibre Networks programme is on track to meet the March 2021 deadline.

Matt Warman: The majority of LFFN projects are on track to meet the March 2021 deadline but there are 15 projects which have had their deadlines extended beyond March 2021. These projects experienced a number of delays, mainly in the procurement phase, but also where suppliers have been delayed in delivering against contractual targets. This resulted in the 15 projects running behind schedule. Without a funding extension, there was a risk that not all of the allocated funding could be drawn before the original March 2021 deadline. Building Digital UK (BDUK) put forward a proposal to HM Treasury recommending an extension to the timeline rather than de-scoping public building fibre upgrades. HM Treasury agreed to this request, and BDUK now expects to complete all of these remaining projects by December 2021. BDUK continue to monitor the impact of COVID-19 on their delivery projects and have undertaken scenario planning activity in line with Cabinet Office guidelines

National Lottery

Carolyn Harris: To ask the Secretary of State for Digital, Culture, Media and Sport, for what reason his Department has not published a response to the consultation entitled, Consultation on the minimum age for playing National Lottery games that closed in October 2019.

Carolyn Harris: To ask the Secretary of State for Digital, Culture, Media and Sport, if he will make it his policy to raise the age for playing the National Lottery to 18 years old.

Carolyn Harris: To ask the Secretary of State for Digital, Culture, Media and Sport, what estimate he has made of the number of children aged between 16 and 18 playing the National Lottery.

Nigel Huddleston: DCMS held a consultation seeking views on whether to raise the minimum age for playing National Lottery games as part of work on the next National Lottery licence, which is due to begin in 2023. The responses are currently being considered and I will formally respond in due course. The consultation on the minimum age for playing National Lottery games provides information on the estimated number of National Lottery players by age brackets which include the age bracket 16 and 17 year olds and 18 to 24 year olds. Estimated number of 16 and 17 year old National Lottery ‘regular players’ based on survey data between April 2016 and March 2019 and population estimates.Played NL draw-based gamesPlayed NL scratchcardsPlayed online instant win games204,000231,000484

Social Security Benefits

Chi Onwurah: To ask the Secretary of State for Digital, Culture, Media and Sport, pursuant to the Answer of 16 July 2020 to Question 72898, what he was referring to when stating in the Computer Weekly article of 9 July 2020 that, Open banking models have allowed those in financial need to share their income to HM Revenue & Customs - fast-tracking their applications for new welfare entitlements.

Mr John Whittingdale: The innovation referred to in the Computer Weekly article of 9 July 2020 is an application in development, identified by the Centre for Data Ethics and Innovation (CDEI) as part of their global repository of the most innovative uses of data in response to the pandemic. The Covid Credit software seeks to help sole traders acquire the relevant banking information needed to self-certify income and show loss to HMRC, using open banking software protocols to retrieve their financial data.

Department for Education

Schools: Coronavirus

Ian Lavery: To ask the Secretary of State for Education, what additional support he plans to provide to schools to ensure that children receive additional emotional and mental wellbeing support on returning to school during the covid-19 outbreak.

Vicky Ford: We know that, across society, the COVID-19 outbreak has had an impact on wellbeing and mental health, but it has had a particular impact on children and young people. That is why, as a government, we have made children’s wellbeing and mental health a central part of our response to the COVID-19 outbreak.Getting children and young people back into education, with settings devoting time to supporting wellbeing, will play a fundamental part in supporting children and young people’s mental health. The return to school will allow social interaction with peers, carers and teachers, which benefits wellbeing. The department has now published detailed plans for all children and young people to return to full-time education from September. The guidance for schools is available here: https://www.gov.uk/government/publications/actions-for-schools-during-the-coronavirus-outbreak/guidance-for-full-opening-schools.We have been working hard to ensure that all pupils and learners will return to a full high-quality education programme in September. Our £1 billion Covid catch-up package, with £650 million shared across schools over the 2020-21 academic year, will support education settings to put the right catch-up and pastoral support in place. More information is available here: https://www.gov.uk/government/news/billion-pound-covid-catch-up-plan-to-tackle-impact-of-lost-teaching-time.As pupils return to school, staff need to be equipped to understand that some children and young people may be experiencing feelings in such as anxiety, stress or low mood as a result of the COVID-19 outbreak, and that these are normal responses to an abnormal situation. Our Mental Health and Behaviour in Schools Advice includes information about what to look for in terms of underlying mental health issues, linked to the graduated response and the support that might be suitable. More information is available here: https://www.gov.uk/government/publications/mental-health-and-behaviour-in-schools--2.The department has also published detailed plans for all children and young people to return to full-time education from September. The guidance highlights the particular need to focus on pastoral support and mental wellbeing as a central part of what schools provide, in order to re-engage them and rebuild social interaction with their friends and teachers. This will involve curriculum provision as well as extra-curricular and pastoral support, and our recently published relationships, sex and health education training module will support teachers with preparation to deliver content on mental health and wellbeing. More information is available here: https://www.gov.uk/guidance/teaching-about-mental-wellbeing.We also remain committed to our joint green paper delivery programme with the Department of Health and Social Care and NHS England, including introducing new mental health support teams and testing approaches to deliver four week waiting times for access to NHS support.Access to mental health support is more important than ever during the COVID-19 outbreak. NHS services remain open. Leading mental health charities are being supported to deliver additional services through the £5 million Coronavirus Mental Health Response Fund. During Mental Health Awareness Week, the government also announced that a further £4.2 million will be awarded to mental health charities, including the Samaritans, Young Minds, and Bipolar UK.The department in collaboration with Public Health England and NHS England, delivered two webinars in July to provide further mental health support. The first webinar was for schools and colleges to support teachers in promoting and supporting the mental wellbeing of children and young people during the COVID-19 outbreak. The second event was for stakeholders across the local system to support strengthening of local partnerships to further support children and young people’s mental health as they return to school. We had around 10,000 sign up to the first webinar and around 1,300 to the second, and they are now available online for wider use.All NHS mental health trusts have been asked to ensure that there are 24/7 open access telephone lines to support people of all ages. Public Health England and Health Education England have also developed advice and guidance for parents and professionals on supporting children and young people’s mental health and wellbeing, which is available here: https://www.gov.uk/government/publications/covid-19-guidance-on-supporting-children-and-young-peoples-mental-health-and-wellbeing.

Apprentices: Taxation

Karin Smyth: To ask the Secretary of State for Education, pursuant to the Answer of 8 July 2020 to Question 64954 on Nurses: Coronavirus, what assessment he has made of the potential merits of extending the deadline of the apprenticeship levy so that NHS trusts do not lose unused funds as a result of the covid-19 outbreak.

Gillian Keegan: We currently have no plans to extend the expiry period for employers’ levy funds. From the point at which funds enter an employer’s account, they already have 24 months in which to spend the funds, and these funds only begin to expire on a rolling, month-by-month basis 24 months after they enter an employer’s account. Levy-paying employers can transfer up to 25% of their annual funds to help support apprenticeship starts in their supply chain or to meet local skills needs. We remain committed to improving the operation of the apprenticeship levy, and while we recognise the current challenges facing employers, we currently consider that this period is sufficient to give employers time to develop their apprenticeship programmes and encourage them to create new apprenticeship opportunities.Employers’ levy funds are not the same as the department's ring-fenced apprenticeship budget. Any unspent funds are not lost but are used to support apprenticeships in smaller employers.To help employers, including NHS trusts, offer new apprenticeships, they will be able to claim £1,500 for every apprentice they hire as a new employee from 1 August 2020 until 31 January 2021- rising to £2,000 if they hire a new apprentice under the age of 25. In addition, we have increased the number of reservations that small and medium sized enterprises (SMEs) can now make through the apprenticeship service, from 3 to 10, enabling them to recruit more apprentices. Details can be found here https://www.gov.uk/government/topical-events/a-plan-for-jobs-2020.The new payment means it’s a great time for employers to offer new apprenticeship opportunities and take advantage of existing flexibilities to train their apprentices in a way that suits their needs.

Apprentices: Taxation

Dan Jarvis: To ask the Secretary of State for Education, what assessment he has made of the potential merits of extending the deadline for employers to claim apprenticeship levy funds by two years.

Gillian Keegan: We currently have no plans to extend the expiry period for employers’ levy funds. From the point at which funds enter an employer’s account, they already have 24 months in which to spend the funds, and these funds only begin to expire on a rolling, month-by-month basis 24 months after they enter an employer’s account. Levy-paying employers can transfer up to 25% of their annual funds to help support apprenticeship starts in their supply chain or to meet local skills needs. We remain committed to improving the operation of the apprenticeship levy, and while we recognise the current challenges facing employers, we currently consider that this period is sufficient to give employers time to develop their apprenticeship programmes and encourage them to create new apprenticeship opportunitiesTo help employers offer new apprenticeships, they will be able to claim £1,500 for every apprentice they hire as a new employee from 1 August 2020 until 31 January 2021- rising to £2,000 if they hire a new apprentice under the age of 25. In addition, we have increased the number of reservations that small and medium sized enterprises (SMEs) can now make through the apprenticeship service, from 3 to 10, enabling them to recruit more apprentices. Details can be found here https://www.gov.uk/government/topical-events/a-plan-for-jobs-2020.The new payment means it is a great time for employers to offer new apprenticeship opportunities and take advantage of existing flexibilities to train their apprentices in a way that suits their needs.

Department of Health and Social Care

Business: Coronavirus

Sir Christopher Chope: To ask the Secretary of State for Health and Social Care, how many offers of help have been received via www.gov.uk/coronavirus-support-from-business; what the maximum time is within which offers are acknowledged; how many substantive responses have been provided; and if he will make a statement.

Jo Churchill: Holding answer received on 27 April 2020



Over 26,000 offers of help have been received by the ‘central support from business’ triage point and survey. All offers are automatically acknowledged by email upon receipt and are followed up with a telephone call.To date, the Crown Commercial Service has made phone contact with most suppliers (around 99.5%) that have made non-medical offers of support. They have also published a catalogue of offers which is designed to make it as easy as possible for offers of non-medical goods and services to be taken up across the public sector. Currently, 9,000 offers are published on the catalogue.The catalogue of offers is available at the following link:https://www.crowncommercial.gov.uk/covid-19/covid-19-buyer-information/catalogue-of-supplier-offers/

Hygiene and Protective Clothing: Manufacturing Industries

Owen Thompson: To ask the Secretary of State for Health and Social Care what plans he has to support small and medium sized businesses to manufacture (a) personal protective equipment and (b) hand sanitiser.

Owen Thompson: To ask the Secretary of State for Health and Social Care, what discussions he has had with the Secretary of State for Business, Energy and Industrial Strategy on acquiring personal protective equipment from SMEs.

Owen Thompson: To ask the Secretary of State for Health and Social Care, what is the minimum quantity of (a) hand sanitiser and (b) personal protective equipment that a private business must produce annually for his Department to include it in a supply chain.

Jo Churchill: There isn't a historic minimum annual amount requirement to be part of the supply chain. The minimum requirements are for volume offered now, not volumes provided historically. Businesses must meet certain minimum financial criteria, must be able to demonstrate that it can supply Personal Protective Equipment (PPE) at volume, and must pass various other checks and controls.Manufacture of PPE must meet product safety legislation outlined in the guidance and appropriate health and safety technical specifications.Lord Deighton is leading the Government effort by British industry to manufacture PPE including hand sanitiser. The Government has contracted with over 175 new suppliers able to deliver at the scale and pace the UK requires. The combined DIT, FCO and DHSC efforts have resulted in DHSC raising purchase orders for over 27.8 billion items of PPE; direct from new relationships in source countries, as well as through our trusted UK suppliers to the NHS, who themselves are using their global connections to help us. We have rapidly processed over 24,000 cases from over 15,000 suppliers to ensure they meet the safety and quality standards that our NHS staff need, as well as prioritising offers of larger volumes. We have so far actively engaged with over 99% of the companies that have offered PPE.

Protective Clothing: North lincolnshire

Andrew Percy: To ask the Secretary of State for Health and Social Care, how many items of personal protective equipment have been delivered to North Lincolnshire and Goole NHS Trust in each of the last eight weeks.

Jo Churchill: Personal protective equipment (PPE) delivery statistics are published online at the following link:https://www.gov.uk/government/collections/ppe-deliveries-statistics-england-weekly-reportsThis is updated on a weekly basis. The total number of PPE items distributed for use by health and social care services (which includes National Health Service trusts) has been published as part of this statistics release since 30 June. These are experimental statistics that the United Kingdom Government continues to develop in line with the requirements of those using the data.

Protective Clothing: Humber Local Resilience Forum

Andrew Percy: To ask the Secretary of State for Health and Social Care, how many items of personal protective equipment have been delivered to the Humber Local Resilience Forum in each of the last eight weeks.

Jo Churchill: Personal protective equipment (PPE) delivery statistics are published online at the following link:https://www.gov.uk/government/collections/ppe-deliveries-statistics-england-weekly-reportsThis is updated on a weekly basis. The total number of PPE items authorised for release to local resilience forums has been published as part of this statistics release since 14 July. These are experimental statistics that the United Kingdom Government continues to develop in line with the requirements of those using the data.

NHS and Social Services: Protective Clothing

Daisy Cooper: To ask the Secretary of State for Health and Social Care, with reference to the statement by the Minister for the Cabinet Office on 2 May 2020, how many of the 149 million masks delivered to NHS and care workers in England from 25 February to 2 May 2020 were (a) surgical masks, (b) disposable particulate respirator masks grade FFP1, (c) disposable particulate respirator masks grade FFP2 and (d) disposable particulate respirator masks grade FFP3.

Daisy Cooper: To ask the Secretary of State for Health and Social Care, how many and what proportion of pieces of personal protective equipment delivered to NHS and care workers via NHS supply chains since 1 January 2020 were (a) masks, (b) goggles, (c) aprons, (d) pairs of gloves, (e) gowns, (f) visors and (g) other categories by (i) surgical level or (ii) grade.

Jo Churchill: Holding answer received on 02 June 2020



The Government is working around the clock to give the social care sector and wider National Health Service the equipment and support they need to tackle this outbreak. The full weight of the Government is behind this effort.We have delivered over 2.4 billion items of personal protective equipment (PPE) across the health and social care system. We have brought together the NHS, industry and the Armed Forces to create a giant PPE distribution network almost from scratch. It is providing drops of critical equipment to 58,000 healthcare settings including general practitioners, pharmacies and social care providers.From 25 February to 31 May we have delivered over 1.57 billion items of PPE across the health and social care system within England, plus tens of millions more will have been distributed by the devolved administrations. This figure includes the following: 208 million masks; 241 million aprons; 2.9 million gowns; and 941 million gloves.

Coronavirus: Nike

Ian Murray: To ask the Secretary of State for Health and Social Care, whether he was made aware of the suspected outbreak of covid-19 at a the Nike international conference in Edinburgh on 26 and 27 February 2020 by (a) Public Health England, (b) Public Health Scotland and (c) the Scottish Government; and if he will make a statement.

Jo Churchill: Holding answer received on 02 June 2020



The Nike international conference held in Edinburgh on 26 and 27 February took place in accordance with scientific advice available at the time.It was agreed by the four Chief Medical Officers ahead of the first confirmed cases of COVID-19 that each administration would announce their own cases and take their own decisions about what is appropriate to release, so this was a matter for the Scottish Government.Public Health England (PHE) was alerted to a case associated with the Nike conference in Edinburgh on 2 March 2020.

Coronavirus: Ethnic Groups

Clive Lewis: To ask the Secretary of State for Health and Social Care, what steps his department is taking to ensure that its review into the effect of covid-19 on BAME communities engages with (a) stakeholders and (b)  people with lived experience.

Jo Churchill: Public Health England (PHE) published its review report ‘Disparities in the risk and outcomes of COVID-19’ on 2 June. The review looked at different factors including ethnicity. The report can be viewed at the following link: https://www.gov.uk/government/publications/covid-19-review-of-disparities-in-risks-and-outcomes The Secretary of State for Health and Social Care has announced that the Parliamentary Under-Secretary of State for Equalities (Kemi Badenoch MP) will be leading on next steps, working with PHE and others. Professor Kevin Fenton from PHE has been engaging with a significant number of individuals and organisations within the black, Asian and minority ethnic community over the past couple of months, to hear their views, concerns and ideas about the impact of COVID-19 on their communities. The valuable insight he has gathered will inform the work the Parliamentary Under-Secretary of State for Equalities is now taking forward.

Coronavirus: Medical Treatments

Rachael Maskell: To ask the Secretary of State for Health and Social Care, what steps he has taken to ensure that the NHS has not discriminated against (a) BAME, (b) elderly (c) other patients with protected characteristics in its provision of treatment during the covid-19 outbreak.

Jo Churchill: We are taking seriously the initial findings from the Public Health England report on disparities in the risk and outcomes from COVID-19. We have publicly set out the work that will be taken forward by the Parliamentary Under-Secretary of State for Equalities (Kemi Badenoch MP) in light of those findings.The National Health Service is committed to tackling discrimination. All NHS providers must comply with the Public Sector Equality Duty, which requires them to have due regard to the need to eliminate discrimination when carrying out their activities. The NHS Standard Contract also places requirements on NHS providers on equity of access, equality and non-discrimination.Throughout the response to COVID-19, NHS England has engaged regularly with a variety of stakeholders including the Health and Wellbeing Alliance, whose members have an understanding of, and provide regular feedback on the needs of different communities.

Dental Services: Coronavirus

Afzal Khan: To ask the Secretary of State for Health and Social Care, what scientific evidence informed the decision to re-open primary care dental services on 8 June 2020.

Jo Churchill: Decisions on the timing of restarting routine services across the National Health Service were made by the NHS on an individual service basis based on overall NHS capacity as well as wider public health considerations. NHS England and NHS Improvement as the commissioner of primary care dental services made the decisions on when to restart practice based dental care outside urgent dental care centres. NHS England and NHS Improvement announced on 28 May that dentists could start to provide NHS care from their practices from 8 June. The information sent to dentists was clear that the pace of the restart should be only as fast as possible compatible with maximizing safety for patients and dental staff. It drew together the current guidance from Public Health England on appropriate infection control procedures and personal protective equipment as it applies to dentistry.

Dental Services: Protective Clothing

Rachael Maskell: To ask the Secretary of State for Health and Social Care, for what reason dental practices providing NHS services are not being supplied with PPE on the same basis as other NHS services.

Jo Churchill: The Government is working closely with industry, the National Health Service, social care providers and the army to ensure that personal protective equipment (PPE) is delivered to those who need it.There are different routes by which sectors of the NHS access PPE. In primary care independent contractors, including dentists, the business as usual access to PPE is via wholesalers. During the pandemic period to ensure continuity of supply the wholesalers are being supplied by the Government with the appropriate PPE for onward sale to dentists, opticians and other independent contractors. NHS England and NHS Improvement are also working together with other agencies to ensure that the over 24,000 dentists who provide NHS care have access to fit testing for the FFP2/3 masks needed to safely deliver many dental procedures.

Coronavirus: South West

James Gray: To ask the Secretary of State for Health and Social Care, what the R value is for the South West; if he will publish any localised variation in that R value; what estimate he has made of future trends in the R value for the South West; what assessment he has made of the cause of the recent increase in the South West R value; and if he will make a statement.

Jo Churchill: The Government Office for Science currently publishes the latest estimates of R in NHS England regions on a weekly basis and these are available at the following link:https://www.gov.uk/guidance/the-r-number-in-the-ukRegional R estimates are more uncertain and variability in the data means they are more likely to fluctuate from one week to the next.Estimates of R for geographies smaller than regional level are less reliable and it is more appropriate to identify local hotspots through, for example, monitoring numbers of cases, hospitalisations, and deaths. Because of this, it is the Scientific Advisory Group for Emergencies’ view that estimating R for such small geographies would not provide meaningful insight, so the Government does not intend to publish more localised estimates.We do not produce forecasts of future trends in the value of R at either national or regional level.The Joint Biosecurity Centre will support local authorities and Public Health Directors to develop local outbreak plans. Working with Public Health England, we will provide an outbreak management toolkit to contain an infection. This will also include agreed triggers and escalation routes to regional or national decision makers if an outbreak is not containable locally.

Coronavirus: Disease Control

Kate Osamor: To ask the Secretary of State for Health and Social Care, when the decision was made, and by which Minister, to remove responses from the stakeholder and community engagement consultation process from Public Health England's Disparities in the risk and outcomes of covid-19 report.

Jo Churchill: I refer the hon. Member to the answer I gave on 1 July 2020 to Question 59534.

NHS: Protective Clothing

Sir Edward Davey: To ask the Secretary of State for Health and Social Care, what (a) amount and (b) value of personal protective equipment has been received by the NHS from (i) foreign governments, (ii) donations from the public and (iii) UK businesses in 2020.

Jo Churchill: Eighty-seven PPE donations have been received from foreign governments, businesses and members of the public since 13 April 2020, this amounts to a total of 53,221,078 items of PPE (as of 27 June). The value of these donations is estimated to be £27,307,664.UK businesses and members of the public have received one hundred and eighty-six PPE donations since 13 April 2020, this amounts to a total of 32,011,472 items of PPE (as of 27 June). These value of this is estimated to be £33,688,871.To note: further to your previous question, the number seems low as it is for the previous financial year, and several of the purchases in February/March will not be reported until the end of the next financial year. I’ve fact checked the numbers with the team, and they’ve confirmed they are correct for this period.

Protective Clothing: Turkey

Justin Madders: To ask the Secretary of State for Health and Social Care, pursuant to the Answer of 9 June 2020 to Question 46094 on Protective Clothing: Turkey, how many items were (a) suitable for use or (b) rejected as unsuitable for use from that shipment.

Jo Churchill: Holding answer received on 22 June 2020



185,000 gowns and coveralls were transported from Turkey to the United Kingdom by the Royal Air Force on 22 April. While a small number of these gowns failed tests in the UK, more passed tests making them suitable for use in the National Health Service.The Turkish Authorities provided 68,000 coveralls when it became clear that an order from a private company was delayed. All have passed the checks and will now be distributed to the frontline. We are working constantly to source personal protective equipment internationally and domestically and more orders are lined up and expected from suppliers in the UK and overseas.

Pharmacy: Coronavirus

Feryal Clark: To ask the Secretary of State for Health and Social Care, with reference the report entitled, Disparities in the risk and outcomes of COVID-19' published by Public Health England, what steps his Department is taking to ensure the safety of pharmacists from (a) BAME backgrounds and (b) other vulnerable groups; and if he will make a statement.

Jo Churchill: Employers in the National Health Service and in the community pharmacy sector have a legal responsibility to protect workers from risk to their health and safety. This includes taking reasonable steps to protect their workers from coronavirus. Their risk assessment should have particular regard to whether the people doing the work are especially vulnerable to COVID-19, for example because they are from a black, Asian and minority ethnic background. Supporting guidance is available, including from NHS Employers. In line with the guidance, NHS organisations are considering a range of mitigating actions, including redeploying staff into alternative roles, and measures such as additional hygiene measures, stringent fit testing procedures for personal protective equipment (PPE), equity of PPE provision and training, and improved occupational health support. The Department has met with bodies representing community pharmacies to set out the legal obligations of employers and point to supporting guidance.

Health Professions: Cancer

Jim Shannon: To ask the Secretary of State for Health and Social Care, if he will take steps to ensure that NHS cancer professionals are not redeployed to work on the response to the covid-19 outbreak.

Jo Churchill: On 8 June 2020, the National Cancer Director, Dame Cally Palmer, and the National Clinical Director for Cancer, Professor Peter Johnson, wrote to the National Health Service system outlining the second phase of NHS response to COVID-19 for cancer services. The letter contained a number of actions to enable cancer services that have been affected by the pandemic to resume and continue to provide care for patients. It is recognised that cancer professionals play an important role in delivering those important services. Further details can be found at the following link:https://www.england.nhs.uk/coronavirus/publication/second-phase-of-nhs-response-to-covid-19-for-cancer-services/

Dental Services

Sir Edward Davey: To ask the Secretary of State for Health and Social Care, how many dental consultations were carried out by NHS dentists in each month in 2020.

Jo Churchill: Data is not held in the format requested.Data is collected and published on the number of National Health Service courses of treatment delivered. This data is published every six months broken down by quarter. The latest data available is for the period ending 30 September 2019 and is available at the following link:https://digital.nhs.uk/data-and-information/publications/statistical/nhs-dental-statistics/2019-20-biannual-report

Blood Cancer: Medical Treatments

Alex Norris: To ask the Secretary of State for Health and Social Care, how many patients with (a) blood cancer and (b) multiple myeloma have had their treatment switched from intravenous to oral treatment during the covid-19 outbreak; and what assessment he has made of the potential long term effect on patients of switching treatment regimens.

Jo Churchill: Holding answer received on 25 June 2020



As at 23 June 2020, 230 patients with myeloma, 32 patients with mantle cell lymphoma, and 28 patients with acute myeloid leukaemia have had applications for treatment with oral therapies approved. These applications were all supported by clinicians.The outcomes related to these new options can only be assessed in the long term and some audits of these patients are already underway.

Coronavirus: Disadvantaged

Karin Smyth: To ask the Secretary of State for Health and Social Care, what steps he is taking to address health inequalities in areas of high deprivation that have been exacerbated by the covid-19 outbreak.

Jo Churchill: Holding answer received on 29 June 2020



Public Health England’s (PHE) report ‘COVID-19: review of disparities in risks and outcomes’, published on 2 June 2020, confirmed that the risk of dying among those diagnosed with COVID-19 was higher in those living in the more deprived areas than those in the least deprived.Every single person deserves to lead a long and healthy life, no matter who they are, where they live, or their social circumstances. We remain committed to levelling up and spreading opportunity around this country, which will be an essential part of the economic and social recovery from this crisis.The Parliamentary Under-Secretary of State for Equalities, (Kemi Badenoch MP), is reviewing the findings from PHE’s reports to better understand the drivers behind the disparities and the relationships between the different risk factors. Her work will help us to improve our understanding of the virus and who it affects so we can build on the existing action we are taking to tackle health inequalities. This includes our childhood obesity plan, NHS Health Checks, our tobacco control plan and diabetes prevention programme. In addition the NHS Long Term Plan commits all major national programmes and every local area across England to set out specific measurable goals and mechanisms by which they will contribute to narrowing health inequalities over the next five and 10 years.

Clipper Logistics: Finance

Helen Hayes: To ask the Secretary of State for Health and Social Care, what estimate his Department has made of the amount of funding awarded to Clipper Logistics to oversee the delivery of personal protective equipment to NHS trusts and Foundation trusts.

Jo Churchill: Holding answer received on 30 June 2020



The contract with Clipper Logistics was put in place by Supply Chain Coordination Ltd, the management function of NHS Supply Chain, via a sub-contract with its existing primary logistics supplier. This was for an initial three-month period from March to June at a value of £1.3 million (monthly extensions at estimated values of £450,000) for storage and distribution of personal protective equipment (PPE) to all National Health Service trusts. This contract was subsequently varied for a three-month period from May to July at a value of £1.95 million (monthly extensions at estimated values of £650,000) to provide an eCommerce solution involving an eBay platform for the storage and distribution of PPE by Clipper to care homes, pharmacies and general practitioner surgeries.

Cancer: Health Services

Dr Philippa Whitford: To ask the Secretary of State for Health and Social Care, what assessment he has made of the effectiveness of local systems and Cancer Alliances on reducing the post-covid-19 outbreak demand for cancer services.

Jo Churchill: No assessment has been made at this time.

Rare Diseases: Drugs

Bob Blackman: To ask the Secretary of State for Health and Social Care, how many and what proportion of medicine assessments conducted by NICE (a) were for medicines for rare diseases since the start of the highly specialised technologies appraisal process in 2013; how many medicines for rare diseases were approved by NICE as a proportion of total approvals since 2013; and how many medicines have been approved via the highly specialised technologies appraisal process since 2013.

Jo Churchill: The National Institute for Health and Care Excellence (NICE) has undertaken 69 assessments considering ‘orphan drugs’ since the start of its highly specialised technologies (HST) programme in 2013.57 of these were appraised by its technology appraisals (TA) programme and NICE made 64 recommendations in total as some topics have multiple recommendations. 49 of these recommendations were positive. A further seven appraisals were terminated as the company did not make an evidence submission. This equates to 16% of NICE’s appraisal activity.86% of NICE’s TA recommendations for orphan drugs have been positive.NICE has published HST guidance on 12 individual topics, making 12 recommendations, all of which have been positive.

Hospitals: Protective Clothing

Stuart Anderson: To ask the Secretary of State for Health and Social Care, what steps he has taken to ensure that all hospitals are adequately supplied with personal protective equipment for (a) staff, (b) patients and (c) visitors.

Jo Churchill: Providing hospitals with adequate personal protective equipment (PPE) and protecting the general public from COVID-19 is the Government’s primary concern. Since 25 February we have delivered over 2.3 billion items of PPE across the health and social care system within England, plus tens of millions more will have been distributed by the devolved administrations. Guidance on PPE for hospital staff, patients and visitors has been published online. Existing guidance covers the wearing of masks for use in clinical settings, both where COVID-19 is confirmed and where it may be present. Staff in non-clinical settings should wear surgical masks, either Type 1 or Type 2. Patient and visitors face coverings can be cloth and/or homemade. However, where applicable, visitors to high risk COVID-19 areas of the hospital or visitors of patients with confirmed COVID-19 must wear appropriate PPE as per the current infection prevention and control guidance.

Hospitals: Remdesivir

Sir Greg Knight: To ask the Secretary of State for Health and Social Care, what assessment he has made of the availability of Remdesivir to NHS hospitals; and if he will make a statement.

Jo Churchill: Holding answer received on 06 July 2020



Remdesivir has been available to National Health Service patients with COVID-19 as part of clinical trials and, most recently, through the Early Access to Medicines Scheme (EAMS). EAMS aims to give patients with life-threatening or seriously debilitating conditions access to medicines that do not yet have a marketing authorisation where there is a clear unmet medical need. Eligible NHS patients will continue to benefit from treatment with remdesivir and the NHS has sufficient stock of remdesivir for patients who need it.

Vertex Pharmaceuticals: Medical Treatments

Alex Norris: To ask the Secretary of State for Health and Social Care, how many times he has met with representatives Vertex Pharmaceuticals to discuss (a) cystic fibrosis treatment and (b) other treatments in the last 12 months.

Jo Churchill: Holding answer received on 06 July 2020



Ministers meet a range of stakeholders, details of which are published quarterly. Details for October – December 2019, the most recently published information, is available at the following link:https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/876059/Q3_Ministers_MEETINGS.csv/previewThe Secretary of State for Health and Social Care met with representatives of Vertex Pharmaceuticals on 8 October 2019 to discuss the availability of cystic fibrosis treatments in England.

Gender Recognition: Children and Young People

Christine Jardine: To ask the Secretary of State for Health and Social Care, with reference to the Minister for Women and Equalities's answer to question 73 at the oral evidence session of the Women and Equalities Select Committee on 22 April 2020, what the Government's policy is on restrictions on medical treatment for gender dysphoria for people under the age of 18.

Jo Churchill: People under 18 are able to access the following medical treatment from gender identity services: psychological assessment, hormone blockers and cross sex hormones.Surgery is not available through the under 18 service.The availability of these treatments is dependent on age as when young people reach the age of 16, they are presumed in law to be competent to give consent for themselves for their own surgical, medical or dental treatment, and any associated procedures, such as investigations, anaesthesia or nursing care.Those under 16 are not automatically presumed to be legally competent to make decisions about their healthcare. However, the courts under the Gillick competence, have stated that under 16s will be competent to give valid consent to a particular intervention if they have “sufficient understanding and intelligence to enable them to understand fully what is proposed”.

Cancer: Vale of York

Julian Sturdy: To ask the Secretary of State for Health and Social Care, what assessment his Department has made of how rapidly routine cancer screening and care in the Vale of York CCG area can return to normal timetables now the Nightingale Hospital Harrogate is being used as a testing centre.

Jo Churchill: The Vale of York Clinical Commissioning Group is working with its health partners to ensure cancer screening in the area can return to full capacity. General practitioner (GP) and hospital services have adapted to manage the impact of the COVID-19 pandemic but are now starting to re-introduce screening safely and in line with national guidance.Throughout the pandemic response, cancer specialist teams at York and Scarborough hospitals have worked to ensure urgent cases continue to be seen promptly, and patients continue to be encouraged to contact their GP via phone or online consultation if they have any concerns.

Protective Clothing: Shops

Mr Kevan Jones: To ask the Secretary of State for Health and Social Care, whether the Government plans to introduce guidance on wearing of face-coverings in retail outlets during the covid-19 outbreak.

Jo Churchill: From Friday 24 July, members of the public must wear a face covering when visiting a shop or supermarket. Guidance that explains what face coverings are, their role in reducing the transmission of COVID-19, the settings in which they are recommended, and how they should be safely used and stored is published online at the following link:https://www.gov.uk/government/publications/face-coverings-when-to-wear-one-and-how-to-make-your-own/face-coverings-when-to-wear-one-and-how-to-make-your-own

Lung Cancer: Medical Treatments

Tulip Siddiq: To ask the Secretary of State for Health and Social Care, what plans his Department has to provide chemotherapy and immunotherapy concurrently for the treatment of lung cancer through the NHS.

Jo Churchill: The following chemotherapy and immunotherapy combinations are available for the treatment of lung cancer in England:- Pembrolizumab with carboplatin and paclitaxel for untreated metastatic squamous non-small-cell lung cancer (National Institute for Health and Care Excellence (NICE) Technology Appraisal 600) [available via the Cancer Drugs Fund];- Pembrolizumab with pemetrexed and platinum chemotherapy for untreated, metastatic, non-squamous non-small-cell lung cancer (NICE Technology Appraisal 577) [available via the Cancer Drugs Fund];- Atezolizumab with carboplatin and etoposide for untreated extensive-stage small-cell lung cancer (NICE Technology Appraisal 368); and- Atezolizumab in combination for treating metastatic non-squamous non-small-cell lung cancer (NICE Technology Appraisal 584).Three other chemotherapy and immunotherapy combinations are currently under review by NICE and NHS England and NHS Improvement await their recommendations.

Coronavirus: Protective Clothing

Dr Philippa Whitford: To ask the Secretary of State for Health and Social Care, what plans are in place to restock personal protective equipment stockpiles before the end of 2020.

Jo Churchill: Holding answer received on 09 July 2020



We are working to expand the supply of personal protective equipment (PPE) from overseas and improve domestic manufacturing capability. We are expanding and improving the logistics network for delivering to the front line.Since 25 February we have delivered over 2.3 billion items of PPE across the health and social care system within England. Almost 30 billion items of PPE have been ordered from United Kingdom-based manufacturers and international partners to provide a continuous supply in the coming months.We continue to model future demand for PPE to cover a range of possible scenarios, working closely with the Scientific Advisory Group for Emergencies to ensure it is underpinned by the latest science. We are confident in the stocks and sources of supply of PPE to meet the needs of health and social care over the next seven and 90 days and are increasingly looking further ahead. We have moved from an emergency situation a few months ago to a stable situation which allows us to prepare with resilience for any second spike or a new wave in the autumn or winter.We are making sure our stockpile is ready for any future wave of the pandemic by ensuring we use lessons learnt and are informed by expert scientific advice.

Genito-urinary Medicine

Caroline Lucas: To ask the Secretary of State for Health and Social Care, what steps his Department is taking to include people disproportionately affected by poor sexual health in the development of the upcoming national sexual and reproductive health strategy.

Caroline Lucas: To ask the Secretary of State for Health and Social Care, whether the national sexual and reproductive health strategy will address (a) sexual health inequalities (b) stigma and discrimination.

Jo Churchill: The development of the national sexual health and reproductive health strategy was paused during the COVID-19 pandemic. Now that we are moving forward with the Government’s COVID-19 recovery strategy, work on the strategy will be restarting shortly. We will consider issues around inequalities, tackling stigma and discrimination and other relevant issues as part of the strategy development.

Coronavirus: Protective Clothing

Justin Madders: To ask the Secretary of State for Health and Social Care, whether he plans to establish an independent expert group other than NERVTAG to adjudicate on whether certain procedures should be regarded as aerosol generating procedures for the purposes of personal protective equipment guidance.

Jo Churchill: Holding answer received on 13 July 2020



An independent panel on aerosol generating procedures is in the course of being established. The panel will provide its expert advice to the four United Kingdom Chief Medical Officers. The terms of reference for the panel are currently being established and a date for the first meeting is being agreed on.

Alcoholism: Prescription Drugs

Paul Bristow: To ask the Secretary of State for Health and Social Care, what steps he is taking to ensure that GPs and commissioners follow the latest NICE guidance on the prescription of drugs for alcohol dependence.

Jo Churchill: National Institute for Health and Care Excellence (NICE) guidance describe best practice and health and care commissioners are expected to take them fully into account. NICE guidance provides recommendations on best practice in terms of both the effectiveness and cost-effectiveness of interventions and services.The Government has taken a robust approach to tackling alcohol harms. Between 2016 and 2020/21 we are investing more than £16 billion in local government public health services. In 2019/20 over £3 billion is to be used exclusively on public health including alcohol treatment services.

Hospitals: Influenza

Jonathan Ashworth: To ask the Secretary of State for Health and Social Care, how many people were admitted to hospital as a result of flu in each year since 2010-11.

Jo Churchill: Holding answer received on 13 July 2020



Public Health England monitors the number of people admitted to hospital with influenza in a sentinel group of National Health Service trusts each year. The number of people admitted to hospital as a result of flu in these trusts, and the mean weekly rate of admission for each season since 2010-11 is attached.

General Practitioners: Ethnic Groups

Stephen Morgan: To ask the Secretary of State for Health and Social Care, what estimate he has made of the number of BAME people who have visited their GP during the covid-19 outbreak.

Jo Churchill: Holding answer received on 14 July 2020



The data requested is not collected or held centrally.

Dental Services: Standards

Dan Jarvis: To ask the Secretary of State for Health and Social Care, what recent estimate he has made of the average waiting time for dental patients; and what steps he is taking to reduce the waiting time.

Jo Churchill: Holding answer received on 14 July 2020



Data measuring waiting times for dental patients, is not held.

World Health Organisation: USA

Sir Edward Davey: To ask the Secretary of State for Health and Social Care, if he will urge the US Administration to reconsider their plans to withdraw from the World Health Organisation; and if he will make a statement.

Jo Churchill: The Department is regularly in discussions with other countries including the United States on a wide range of issues relating to the international response to COVID-19. The United States continues to play an important role on global health, and we will continue to work with the United States and other international partners to tackle the current crisis. The United Kingdom has a strong and committed relationship with the World Health Organization (WHO) and, as the second largest Member State donor, continues to work closely with the WHO. The United Kingdom has already contributed £75 million to help the WHO-led international efforts to stop the spread of the virus and end the pandemic and the UK has no plans to stop funding the WHO, which has an important role to play in leading the global health response to COVID-19.

Breast Cancer: Prosthetics

Caroline Nokes: To ask the Secretary of State for Health and Social Care, what the waiting times were for breast prosthetics in (a) 2018 and (b) 2019 by NHS Trust.

Caroline Nokes: To ask the Secretary of State for Health and Social Care, what the current waiting times are for breast prosthetics at each NHS trust.

Jo Churchill: Information is not held in the format requested.

Protective Clothing: Procurement

Rachel Reeves: To ask the Secretary of State for Health and Social Care, how much money from the public purse has been spent with small and medium-sized businesses in the procurement of personal protective equipment.

Jo Churchill: Holding answer received on 16 July 2020



The Department has a small and medium-sized enterprises (SME) Action Plan to achieve its SME target of 23% of procurement spend going to SMEs by March 2022. The calculation and validation process for the proportion of spend on SMEs across different procurement categories for each closed financial year is usually undertaken and reported on in August of the following financial year, so information on this spend is not yet available for 2019/20.

Protective Clothing: Procurement

Rachel Reeves: To ask the Secretary of State for Health and Social Care, what plans his Department has to maximise opportunities for UK-based companies to fulfil orders of personal protective equipment.

Jo Churchill: Holding answer received on 16 July 2020



Lord Deighton is leading the Government effort to unleash the potential of British industry to manufacture personal protective equipment (PPE) for the health and social care sectors. This will maximise opportunities for United Kingdom-based companies to fulfil orders of PPE.Almost 28 billion items of PPE have been ordered overall from UK-based manufacturers and international partners to provide a continuous supply in the coming months. More than 30 deals have been struck with companies through the Make initiative to manufacture and deliver PPE in the UK. We are also working with over 175 new suppliers to deliver at the scale and pace the UK requires. Around 20% of all PPE will be manufactured in the UK by the end of the year.

Ophthalmic Services

Bambos Charalambous: To ask the Secretary of State for Health and Social Care, what estimate he has made of the number of people that have not attended their outpatient ophthalmology appointment since the start of 2020.

Jo Churchill: A count of outpatient appointments by ‘attend or did not attend’ type for ophthalmology in England from 1 January 2020 is provided in the following table. Data provided are not a count of individual patients as a patient may have had more than one appointment within the time period. Data for 2020 are provisional and subject to change until the finalised data are published:Attend or did not attend’ type codes and descriptionJanuaryFebruaryMarchAprilMayAppointment cancelled by, or on behalf of, the patient83,55078,728115,56252,95825,707Did not attend – no advance warning given63,95454,91861,18620,49617,021Appointment cancelled or postponed by the Health Care Provider74,74571,466140,989203,933112,541Seen, having attended on time or, if late, before the relevant care professional was ready to see the patient759,599688,583533,189256,201269,040Arrived late, after the relevant care professional was ready to see the patient, but was seen9,5498,5436,1212,0922,421Did not attend – patient arrived late and could not be seen522158205148127Not known5,0315,1997,9698,7296,354Source: Hospital Episode Statistics, NHS Digital

General Practitioners: Coronavirus

Catherine West: To ask the Secretary of State for Health and Social Care, what guidance his Department has issued to GPs to help (a) identify and (b) support people displaying signs of long term covid-19 related symptoms.

Jo Churchill: Holding answer received on 16 July 2020



NHS England and NHS Improvement published guidance for general practitioners on the after-care needs of in-patients recovering from COVID-19 on 25 June 2020 at the following link:https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/06/C0388-after-care-needs-of-inpatients-recovering-from-covid-19-5-june-2020-1.pdfOn 5 July the new ‘Your COVID Recovery’ service was announced. This forms part of National Health Service plans to expand access to COVID-19 rehabilitation treatments for those who have survived the virus but still have problems with breathing, mental health problems or other complications.By guaranteeing financial support and temporarily reducing the current Quality Outcome Framework requirements, NHS England and NHS Improvement are also releasing capacity in general practice to focus on COVID-19 recovery, and so supporting those patients most in need of long-term condition management support.

Prescription Drugs: Fees and Charges

Mary Glindon: To ask the Secretary of State for Health and Social Care, how many people have had to pay for an additional prescription as a result of their medication being recalled as a result of safety concerns in each year since 2015.

Jo Churchill: If a prescription item is recalled, the patient is issued with a new prescription for an alternative product which will then be dispensed as a separate item. The prescriptions data systems are unable to identify this as a replacement product, therefore this information is not held centrally.

Prescriptions: Fees and Charges

Mary Glindon: To ask the Secretary of State for Health and Social Care, how many people paid for a prescription in each year since 2015.

Jo Churchill: Data on prescriptions dispensed in the community is collected by the number of items, or the cost. Data is not held about the number of people who obtain a prescription.

NHS Low Income Scheme

Mary Glindon: To ask the Secretary of State for Health and Social Care, how many people received financial support from the NHS low income scheme, HC2 certificate in (a) 2015, (b) 2016, (c) 2017, (d) 2018 and (e) 2019.

Jo Churchill: The NHS Business Services Authority processes the NHS Low Income Scheme and issues HC2 certificates. It does not hold data on how many people have used their certificate after it is issued; and multiple people in a household in addition to the applicant might be covered by a certificate, including partner and children. However, data is supplied on the number of HC2 certificates issued in 2014/15, 2015/16, 2017/18 and 2018/19. This is shown in the following table:PeriodNumber of HC2 certificates issued2014/15214,9752015/16225,2392016/17214,8672017/18206,5992018/19182,661 Data is recorded April-March. Data provided is recorded on a monthly basis and recorded in the NHS Low Income Scheme Annual Statistics Report. This data relates to the number of certificates issues, not the number of people supported by the NHS Low Income Scheme.

Prescriptions: Coronavirus

Mary Glindon: To ask the Secretary of State for Health and Social Care, whether he plans to make an assessment of the adequacy of the system for prescription (a) charges and (b) exemptions as a result of the effect of the covid-19 outbreak.

Jo Churchill: There are no plans to make such an assessment or to change the system for prescription charges and exemptions. Prescription charges are a valuable income source for the National Health Service and are particularly important given increasing demands on the NHS. Extensive arrangements are already in place to help people access NHS prescriptions, including a broad range of NHS prescription charge exemptions.

Prescription Drugs

Mary Glindon: To ask the Secretary of State for Health and Social Care, what assessment he has made of the effect of taking over-the-counter medicines off prescription in England on (a) prescription charge revenue and (b) health outcomes.

Jo Churchill: No assessment has been made of the effect on prescription charge revenue of the guidance on ‘Conditions for which over the counter items should not routinely be prescribed in primary care’.

Prescriptions: Fees and Charges

Mary Glindon: To ask the Secretary of State for Health and Social Care, how many people paid for a prescription between (a) January 2019 and June 2019 and (2) January 2020 and June 2020.

Jo Churchill: This information is not collected centrally.

Coronavirus: Vaccination

Ruth Jones: To ask the Secretary of State for Health and Social Care, what the Government's policy is on publishing the terms of bilateral agreements with (a) AstraZeneca and (b) other pharmaceutical companies for the development of covid-19 vaccines.

Jo Churchill: Holding answer received on 16 July 2020



The United Kingdom Government is committed to transparency across its operations to enable the public to hold public bodies and politicians to account, including commitments relating to public procurement. Central Government buyers publish all contract information on Contracts Finder where the value of the contract is over £10,000. This will include contracts in relation to COVID-19 vaccines. The Contracts Finder is available at the following link:https://www.gov.uk/contracts-finderThere are measures in places to identify, assess and protect information that is sensitive and should therefore be redacted (removed and not published). We will use the exemptions set out by the Freedom of Information Act 2000 as the criteria for assessing what information should be redacted.

Coronavirus: Protective Clothing

Janet Daby: To ask the Secretary of State for Health and Social Care, what steps have been taken to provide appropriate personal protective equipment to NHS staff with religious beards.

Janet Daby: To ask the Secretary of State for Health and Social Care, what steps he has taken to provide personal protective equipment for NHS staff with (a) turbans and (b) other religious head coverings.

Jo Churchill: We are clear frontline staff should have the equipment they need to do their job safely. The National Medical Director and Chief Nursing Officer of NHS England and NHS Improvement wrote on 24 April 2020 to NHS Chief Executives, Chief Nurses and Medical Directors, emphasising the importance of proper fit testing of disposable sessional personal protective equipment (PPE) face masks (such as FFP3 masks). The Government is dedicated to providing appropriate fitting PPE for all frontline staff, including those with religious beards, turbans and other religious head coverings.We are also working to secure products for specific groups of patients and staff, for example, having 2,000 powered respirators that Sikh male doctors or others who cannot fit test well against masks will be able to use.

Health Services: Protective Clothing

Fleur Anderson: To ask the Secretary of State for Health and Social Care, what steps he is taking to provide scrubs to (a) hospitals, (b) care homes and (c) dentists which rely on donations of scrubs from charitable volunteers.

Jo Churchill: Holding answer received on 16 July 2020



NHS Supply Chain, the main provider of consumables and equipment into the National Health Service, report that its suppliers have sufficient supplies of scrubs for NHS customers to order. Care homes and dental practices access scrubs from their business as usual wholesalers and we have set up a number of new access points and distribution routes whereby all items of personal protective equipment, including gowns and aprons, can be ordered.

Coronavirus: Mortality Rates

Barbara Keeley: To ask the Secretary of State for Health and Social Care, with reference to reports of variable mortality rates from covid-19 between NHS Trusts and regions, what the age-standardised mortality rate from covid-19 is in (a) Salford Royal Foundation Trust, (b) Greater Manchester, (c) the North West and (d) England.

Jo Churchill: Holding answer received on 16 July 2020



The Office of National Statistics (ONS) has published age-standardised mortality rates by country, region, local authority and Middle Layer Super Output Areas. The report published on 12 June 2020 can be accessed at the following link:https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/deathsinvolvingcovid19bylocalareasanddeprivation/deathsoccurringbetween1marchand31may2020/Between 1 March and 31 May 2020, the age-standardised mortality rate (ASMR) published by the ONS was 81.9 per 100,000 persons in England, 98.9 per 100,000 persons in the North West, and 135.5 in Manchester Local Authority. ASMR by National Health Service trusts are not published by the ONS.

Tobacco: Marketing

Mr David Jones: To ask the Secretary of State for Health and Social Care, with reference to the decision by the US Food and Drug Administration to authorise the marketing of the IQOS electrically heated tobacco system as a modified risk tobacco product in the US, if he will (a) undertake a review of policy in relation to such products in the UK and (b) introduce a regulatory framework for those goods based on risk.

Jo Churchill: Holding answer received on 16 July 2020



On 7 July 2020, the United States Food and Drug Administration’s (FDA) classified IQOS as a ‘modified risk product’ and permitted the use of certain information in their advertising and marketing of the products. The FDA states that this does not mean these products are safe or “FDA approved” and they will continue to monitor them.The Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment (COT) provided an independent assessment of the harms of heated tobacco products for the Government. COT reported in December 2017 and found that the evidence suggests heated tobacco products pose a risk to users and though there is likely to be a reduction in risk for cigarette smokers who switch to these products, it is best to quit entirely.In the United Kingdom heated tobacco products are regulated under the Tobacco and Related Products Regulations 2016 (TRPR) and classed as a novel tobacco product. The Government has a legal commitment to carry out a post-implementation review of TRPR by May 2021.

Tobacco: Sales

David Morris: To ask the Secretary of State for Health and Social Care, what assessment he has made of the level compliance with the prohibition on the sale of menthol cigarettes under the EU Revised Tobacco Products Directive.

Jo Churchill: No assessment has been made. We expect the tobacco industry to comply with the requirements of The Tobacco and Related Products Regulations 2016, and this includes the recent ban on the sale of menthol flavoured cigarettes. A breach of the regulations could result in enforcement action being taken.

Coronavirus: Air Pollution

Geraint Davies: To ask the Secretary of State for Health and Social Care, whether he has made an assessment of the effect of air pollution caused by fireworks and bonfires on the spread of covid-19.

Jo Churchill: Public Health England has made no assessment of the effect of air pollution caused by fireworks and bonfires on the spread of COVID-19.Older people, individuals with existing cardio-respiratory diseases and pregnant women who are most susceptible to air pollution are also at an increased risk of severe illness from COVID-19. There is no clear evidence yet to suggest that air pollution has a direct link to the spread or severity of COVID-19. If individuals are directly affected by smoke, they should avoid the area. If there is visible smoke they are advised to stay indoors and keep their doors and windows closed.

Care Homes: Hospitals

Ben Lake: To ask the Secretary of State for Health and Social Care, what the average cost is of transporting a patient from hospital to their home or suitable care facility.

Jo Churchill: The information is not available in the format requested.

Meat: Fraud

Sir Greg Knight: To ask the Secretary of State for Health and Social Care, how many successful prosecutions there have been by each local authority for meat fraud in each of the last five years; what recent assessment he has made of the veracity of the sampling data submitted by local authorities to the UK Food Surveillance System; and if he will make a statement.

Jo Churchill: Holding answer received on 20 July 2020



The total number of successful prosecutions for meat fraud that local authorities reported to the Food Standards Agency or Food Standards Scotland in each of the last five years is provided in the following table. In each case the prosecution was taken by a different local authority. 2015201620172018201941300 Data submitted to the UK Food Surveillance System does not provide a comprehensive picture of samples taken by local authorities and the reported results cannot be used to determine the extent of any specific issue across the United Kingdom. This is because some but not all local authorities report results using the system and sampling is used as part of a targeted approach rather than being conducted on a random and representative basis.

Asthma: Steroid Drugs

Rachael Maskell: To ask the Secretary of State for Health and Social Care, with reference to the NHS Long Term Plan, what progress has been made on the (a) delivery of and (b) timescales to tackle the over-reliance on short-acting beta agonist inhalers in asthma treatment.

Jo Churchill: Respiratory disease is a clinical priority of the NHS Long Term Plan. We are informed by NHS England and NHS Improvement that prior to the COVID-19 pandemic, an average of 2.25 million short-acting beta agonist (SABA) inhalers were prescribed per month in England. This over-use of aSABA inhalers can occur for multiple reasons and the work of the national respiratory programme is looking to address these issues as part of the NHS Long Term Plan, the Community Pharmacy Contractual Framework for 2019/20 to 2023/24 and the Quality Outcomes Framework (QOF).These developments complement the work of other national quality improvement initiatives such as the asthma national audit programme.The Community Pharmacy Contractual Framework for 2019/20 to 2023/24 includes: “The pharmacy can show evidence that asthma patients, for whom more than 6 short-acting bronchodilator inhalers were dispensed without any corticosteroid inhaler within a 6 month period, have since the last review point been referred to an appropriate health care professional for an asthma review”.The QOF ensures all practices establish and maintain a register of patients with an asthma diagnosis in accordance with National Institute for Health and Care Excellence guidance. An update to the GP contract for 2020/21-2023/24 includes an improved QOF asthma domain. The content of the asthma review has been amended to incorporate aspects of care positively associated with better patient outcomes and self-management.

Asthma: Medical Equipment

Rachael Maskell: To ask the Secretary of State for Health and Social Care, what assessment he made of the implications of reliever inhalers for the carbon footprint of propellant inhalers when establishing the metric in the Primary Care Network Contract to tackle that footprint; and for what reason reliever inhalers were excluded from that metric.

Jo Churchill: We are informed by NHS England and NHS Improvement that carbon impact of reliever inhalers was reviewed when establishing the proposed indicator as part of the Investment and Impact Fund in the Network Contract Direct Enhanced Services (DES). The final version of the Network Contract DES did not include the Investment and Impact Fund proposals for the first six months of the 2020/21, to ensure Primary Care Networks were able to focus on the COVID-19 pandemic.The original proposal provided an opportunity to encourage a move towards lower carbon inhalers, where clinically appropriate and as part of regular medicines review, within the evidenced range of existing local prescribing practice. Reliever (SABA) inhalers were not included in the proposals at this stage, given the clinical evidence that an MDI inhaler may remain more appropriate where used for exacerbations (such as asthma attacks). However, NHS England and NHS Improvement are simultaneously pursuing a variety of strategies to also support a shift away from high-carbon SABA options where this can be done in a safe and clinically appropriate way.

Public Health: Coronavirus

Mr Ben Bradshaw: To ask the Secretary of State for Health and Social Care, what steps he is taking to ensure public health advice on covid-19 is available in the major languages spoken in England.

Jo Churchill: Public Health England has published translations of updated core public health guidance into the 10 most commonly spoken languages (other than English) in the United Kingdom. This information has been translated into the following languages: Arabic, Bengali, Chinese: simplified, Chinese: traditional, French, Gujarati, Polish, Portuguese, Punjabi, Urdu.

Influenza: Vaccination

Dr Philippa Whitford: To ask the Secretary of State for Health and Social Care, what estimate he has made of how many additional flu vaccines will be provided in the lead up to the 2020 Winter period compared to the number of such vaccines administered in 2019.

Jo Churchill: Holding answer received on 20 July 2020



The flu vaccination programme is a crucial part of preparing the United Kingdom for winter. The vaccine is already available to those most at risk of flu, children aged 2-3, all primary school aged children and all healthcare workers. In 2019/20 over 14.6 million doses of the flu vaccine were administered to these groups.As part of our planning for this coming winter, we are seeking to increase uptake for all the cohorts who are currently eligible for flu vaccination and extend who is eligible. Information on the ambitions for flu vaccine uptake will be published in the second annual flu letter 2020/21.General practitioners and community pharmacists are directly responsible for ordering flu vaccine from suppliers for the adult flu programme, and advice was issued to them about ordering sufficient doses of vaccine for their patient groups.

Day Care: Children

Tulip Siddiq: To ask the Secretary of State for Health and Social Care, what steps he is taking to ensure that GPs complete health declaration forms required for people applying to set up childminding businesses.

Tulip Siddiq: To ask the Secretary of State for Health and Social Care, what assessment his Department has made of the health risks of health declaration forms being completed in physical form during the covid-19 outbreak.

Jo Churchill: Holding answer received on 20 July 2020



Much of the work undertaken by general practitioners (GPs) in completing health declaration forms for patients is private (e.g. non-contractual). In recognition of the health risks of continuing to fill these in in physical form, as well as to free up GPs’ time to respond to the pandemic, in March 2020 NHS England and NHS Improvement wrote to the primary care sector, requesting that all practices consider stopping any private work they were doing to help free up capacity.

Hormone Replacement Therapy

Steve McCabe: To ask the Secretary of State for Health and Social Care, what progress his Department has made on tackling the shortage of Hormone Therapy Replacement patches.

Steve McCabe: To ask the Secretary of State for Health and Social Care, what assessment his Department has made of the (a) effectiveness and (b) safety of using alternatives to Hormone Therapy Replacement patches.

Jo Churchill: We have been working closely with all suppliers of Hormone Replacement Therapy (HRT) preparations to maintain overall supply to patients. Supplies of alternative HRT products continue to remain available and the situation has been improving steadily since the end of February 2020.The National Institute for Health and Care Excellence has made an assessment of the clinical and cost effectiveness of HRT, including transdermal patches, and has made recommendations on their use in its guideline on menopause: diagnosis and management [NG23].The safety and efficacy of individual products that are authorised for the relief of oestrogen deficiency symptoms associated with the menopause are assessed at the time each product is licensed and safety is continuously monitored once it is on the market.Most post-marketing studies examine the safety of HRT products as a group and the safety of HRT products as a class has been kept under continuous review by the Medicines and Healthcare products Regulatory Agency (MHRA) in conjunction with its independent scientific advisory body, the Commission on Human Medicines (CHM) and its Expert Advisory Group on Medicines for Women’s Health. Likewise, the safety of licensed medicines and herbal products that are used as alternatives to HRT are continuously monitored by the MHRA and advice sought from the CHM, as needed, when new safety issues arise.

Genito-urinary Medicine: Equality

Helen Hayes: To ask the Secretary of State for Health and Social Care, what steps he is taking to ensure that the national sexual and reproductive health strategy takes into account (a) structural inequalities relating to and (b) social determinants of sexual ill-health.

Jo Churchill: Holding answer received on 20 July 2020



The development of the national sexual health and reproductive health strategy was paused during the COVID-19 pandemic. Now that we are moving forward with the Government’s COVID-19 recovery strategy, work on the strategy will be restarting shortly. We will consider issues around inequalities and other relevant areas as part of the strategy development.

Coronavirus: Air Pollution

Geraint Davies: To ask the Secretary of State for Health and Social Care, what steps he is taking to ensure the safety of employees and customers in offices and shops at risk of contracting covid-19 as a result of increased exposure to PM2.5 fine particle pollution.

Jo Churchill: Holding answer received on 20 July 2020



Public Health England is not aware of any increase in exposure to PM2.5 fine particulate matter to members of the public and employees in offices and shops.

Children and Young People: Coronavirus

Mick Whitley: To ask the Secretary of State for Health and Social Care, what steps he has taken to ensure that guidance issued by his Department in relation to covid-19 is (a) accessible by children and young people and (b) communicated to children and young people.

Jo Churchill: Holding answer received on 20 July 2020



Public Health England (PHE) has worked with members of the National Health Service Youth Forum and ‘I Will’ Ambassadors to create COVID-19 guidance that is more accessible for young people. PHE has tailored guidance by adapting the advice, resources and language to be more relevant to young people aged 11-19 years. The published information includes advice on social distancing, shielding, looking after your wellbeing and the benefits of youth social action. The guidance is available at the following link:https://riseabove.org.uk/article/stayhomefeelgood/PHE has also published an ‘easy read’ version of the shielding guidance so that anyone with more limited reading skills can access online or in printed format.

Coronavirus: Employment

Liz Saville Roberts: To ask the Secretary of State for Health and Social Care, what discussions he has had with Cabinet colleagues on establishing support packages for people shielding whose workplaces cannot be made covid-safe when shielding provisions end on 1 August 2020.

Jo Churchill: Holding answer received on 20 July 2020



We are continuing to work across Government to ensure that clinically extremely vulnerable people can return to work safely. Further guidance will be issued on 1 August 2020.